ABSTRACT
Resection of the stomach is still the principal method for surgical management of gastric and duodenal ulcer. The functional condition of the anastomosis depends on the method used. The authors conducted comparative endoscopic evaluation of anastomoses formed after Hofmeister-Finsterer, Billroth I, Andreo and Vitebsky according to the following criteria: shape and diameter; contractile and obturator function; gastrointestinal reflux; morphological changes in the zone of the anastomosis and the gastric stump. The authors analyse their own material concerning fibrogastroscopy in 168 patients after gastric resection, the anastomosis was established after Hofmeister-Finsterer in 93 of them after Vitebsky in 46, after Billroth I in 21, and after Andreo in 8. Vitebsky's modification of Billroth II anastomosis and Andreo's modification of Billroth I anastomosis possess the best functional capacities. Billroth I and Billroth II gastroenterostomy in Hofmeister-Finsterer's modification do not possess contractile and obturator property, which promotes reflux of bile into the gastric stump and the development of reflux gastritis and other complicating factors.
Subject(s)
Bile Reflux/prevention & control , Duodenum/surgery , Gastrectomy/methods , Jejunum/surgery , Peptic Ulcer/surgery , Postgastrectomy Syndromes/prevention & control , Stomach/surgery , Anastomosis, Surgical/methods , Bile Reflux/etiology , Gastroscopy , Humans , Postgastrectomy Syndromes/etiologySubject(s)
Pyloric Stenosis/surgery , Adult , Aged , Female , Humans , Male , Middle Aged , Peptic Ulcer/surgery , Postoperative Complications , Pyloric Stenosis/etiologyABSTRACT
An analysis of 120 patients with multiple trauma is given. The authors believe that the question of diagnostics of the injuries, the succession of using diagnostic methods should be solved collectively. A conclusion has been made that urgent surgery in complex with resuscitation measures must be performed in patients with internal hemorrhage, increasing intracranial hematoma, tamponade of the pericardium, increasing hemopneumothorax.
Subject(s)
Abdominal Injuries/diagnosis , Thoracic Injuries/diagnosis , Abdominal Injuries/surgery , Adult , Emergencies , Hospitalization , Humans , Middle Aged , Thoracic Injuries/surgeryABSTRACT
The authors describe results and the technique of treatment of diffuse fecal and purulent peritonites by an open method in 15 patients. Three patients died. Small intestinal fistulas were observed as complications of laparostomy in three cases.
Subject(s)
Laparotomy , Peritonitis/surgery , Acute Disease , Adult , Feces , Female , Humans , Laparotomy/methods , Male , Middle Aged , Peritonitis/complicationsABSTRACT
High incidence of diagnostic errors in thoracoabdominal wounds is due to the critical state of the patients, insufficient clinical examination and underestimation of localization of the wound hole. Errors in diagnosis result in the incorrect sequence of surgical procedures, time loss during the arrest of bleeding, use of traumatic operative accesses.
Subject(s)
Abdominal Injuries/diagnosis , Thoracic Injuries/diagnosis , Abdominal Injuries/complications , Abdominal Injuries/surgery , Diagnostic Errors , Female , Humans , Male , Thoracic Injuries/complications , Thoracic Injuries/surgeryABSTRACT
An analysis of the observation of 107 patients has shown the etiological factors of the appearance of postoperative ventral hernias to be varied: lowered resistance of the patient's organism to infection, choice of an irrational operative access, insufficient hemostasis, carelessness in handling with tissues during operation, severe concomitant diseases, erroneously chosen method of anesthesia. Peridural anesthesia is recommended for the operative treatment of ventral hernias.
Subject(s)
Hernia, Ventral/epidemiology , Adult , Age Factors , Follow-Up Studies , Hernia, Ventral/etiology , Hernia, Ventral/surgery , Humans , Middle Aged , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Postoperative Complications/surgery , Time FactorsABSTRACT
The surgeon's tactics in appendicular infiltrate should be chosen following a complete examination of the patient and careful observation. Appendectomy is indicated in loose appendicular infiltrate. Conservative therapy is a method of choice for the treatment of a dense appendicular infiltrate. Periappendicular abscess should be opened and drained.
Subject(s)
Abscess/surgery , Appendicitis/complications , Peritonitis/surgery , Abscess/diagnosis , Adolescent , Adult , Aged , Appendectomy/methods , Appendicitis/diagnosis , Appendicitis/surgery , Child , Child, Preschool , Drainage , Female , Humans , Infant , Male , Middle Aged , Peritonitis/diagnosis , Preoperative Care/methods , Time FactorsABSTRACT
The control fibrogastroscopy of the resected stomach in patients showing the clinical picture of postoperative anastomositis has proved that the application of an unresolving suture material (caprone) for a marginal suture of gastroenteroanastomosis causes post-resection inflammation of anastomosis in about 50% of cases. For improvement of surgical results the authors suggest to substitute marginal caprone sutures with catgut or tantal agraffes.
